Achieving Perfect Hand Washing: an Audit Cycle with Surgical Internees

Area of Science:

• Medical Microbiology
• Infection Control
• Surgical Safety

Background:

• Surgical site infections are a significant concern in healthcare settings.
• Inadequate surgical hand antisepsis is a primary factor contributing to infection transmission.
• Improving compliance with hand hygiene protocols is crucial for patient safety.

Purpose of the Study:

• To achieve 100% compliance in surgical hand antisepsis.
• To identify specific areas of non-compliance in hand hygiene.
• To evaluate the efficacy of different interventions for improving compliance.

Main Methods:

• A 6-day audit of surgical hand antisepsis compliance was conducted in a tertiary care hospital.
• Baseline compliance was recorded, followed by interventions including video demonstration, personal demonstration, and individual instruction.
• Compliance rates were monitored after each intervention among 42 surgical interns.

Main Results:

• Baseline compliance was 33.59%, significantly increasing to 100% within 6 attempts (p=0.0294).
• Personal instruction was identified as the most effective intervention for improving compliance.
• Surgical hand washing technique required the most attempts (n=6) to rectify.

Conclusions:

• Audit cycles are effective in improving surgical hand antisepsis compliance.
• Video-based and individual instruction are valuable teaching tools for surgical hand disinfection.
• Understanding reasons for non-compliance is key to developing targeted interventions.